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Cryptococcal disease, particularly cryptococcal meningitis is a significant cause of morbidity and mortality among people living with HIV with advanced HIV disease. It is estimated that it is respon
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sible for nearly 19% of AIDS-related mortality, second only to tuberculosis. Rapid screening, diagnosis and linking to appropriate treatment are critical actions national programs must take to reduce the burden of disease.
WHO in 2022 introduced updated guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. This policy brief provides a summary of the key recommendations, clinical considerations, and also stresses the importance of ensuring access to life-saving antifungals. There is an urgent need for countries to scale-up management for not just cryptococcal meningitis, but address cryptococcal disease in the context of a package of care for advanced HIV disease as recommended by WHO.
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The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t
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he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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Consolidated guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection
recommended
2nd edition. These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and t
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he care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care
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HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV
World Health Organization
(2013)
These guidelines provide specific recommendations and expert suggestions — for national policy-makers and programme managers and their partners and stakeholders— on prioritizing, planning and providing HIV testing, counselling, treatment and car
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e services for adolescents
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Good practice examples from India
The curriculum, which complements the national pediatric ART training, was finalized in 2011 and was subsequently implemented nationally. The training curriculum includes a 15-module Trainer Manual, a Participant Manual, and accompanying PowerPoint slides.
Responses of the Catholic Church to HIV and AIDS in Africa: Lessons learned
Fleischer, K., et al.
German Bishops' Conference Research Group on International Church Affairs
(2015)
CC
An international field study by African and German theologicans and health workers.
These guidelines – an update to the World Health Organization’s 2015 publication Consolidated strategic information guidelines – present a set of essential aggregate indicators and guidance on choosing, collecting and systematically analysing strategic information to manage and monitor the nat
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ional health sector response to HIV.
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This publication by UNAIDS, UNDP and the International Organisation for Migration examines various dimensions related to migration and HIV and AIDS.
The new WHO guidelines recommend that people living with HIV be started on antiretrovirals (ARVs) as soon as possible after being diagnosed. Currently, many people living with the virus globally must wait until their CD4 counts fall to 500 to start
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treatment. According to the WHO, the move to early treatment –or what some have dubbed the “test and treat” model –is backed by the latest research.
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Accessed August 2018
